Today’s Top Story
Study: Among trauma patients, obesity linked to longer stay, higher charges, more orthopaedic surgical interventions.
According to data published in the in the Nov. 18 issue of The Journal of Bone & Joint Surgery, trauma patients who are obese may be at increased risk of higher hospital charges, longer stays, discharge to a continuing-care facility, and higher rates of orthopaedic surgical intervention. The research team reviewed prospectively collected information on 301 polytrauma patients at a single center, 21.6 percent of whom were classified as obese (truncal three-dimensional reconstruction body mass index [BMI] ≥30 kg/m2). The research team found that patients with an obese truncal BMI had longer hospital length of stay, more days in intensive care, more frequent discharge to a long-term care facility, higher rate of orthopaedic surgical intervention, and increased total hospital charges, compared to patients who were not obese. Read more…
Read the abstract…
Other News
Citing ethical concerns, advocacy groups call for a halt to two clinical trials investigating resident work hours.
The consumer advocacy group Public Citizen and the American Medical Student Association have requested that federal regulators and accrediting organizations stop two ongoing investigations into the effect of extended resident work hours that the organizations say are “highly unethical.” Both trials require first-year medical residents to work shifts of 28 consecutive hours or more—nearly twice the current maximum number of hours allowed by the Accreditation Council for Graduate Medical Education (ACGME) for such residents. “Substantial evidence shows that sleep deprivation due to excessively long work shifts increases the risk of motor vehicle accidents, needle-stick injuries and exposure to blood-borne pathogens, and depression in medical residents,” the organizations say in a statement. “It also exposes their patients to an increased risk of medical errors, sometimes leading to patient injuries and deaths.” Read more…(registration may be required)
Read the press release from Public Citizen and the American Medical Student Association…
View related information, including links to the letters and a list of participating institutions…
Study: Many orthopaedic devices are modified following FDA PMA approval.
Findings published online in the journal Clinical Orthopaedics and Related Research suggest that considerable device modification may occur after medical devices are brought to market after undergoing the U.S. Food and Drug Administration (FDA) premarket approval (PMA) process. The authors reviewed information on 70 PMA-approved orthopaedic devices (34 peripheral joint implants or prostheses, 18 spinal implants or prostheses, and 18 other devices or materials). They found that the devices underwent a median 6.5 postmarket changes during their lifespan, or 1.0 changes per device–year. Overall, the rate of new postmarket device changes approved per active device increased from fewer than 0.5 device changes per year in 1983 to just fewer than three device changes per year in 2014. The authors found that, among 765 total postmarket changes across all devices, 172 (22 percent) altered device design or components. Read the abstract…
Study: Assessment program may help reduce risk of falls for older patients.
Data presented at the annual scientific meeting of the Trauma Quality and Improvement Program suggest that implementation of a comprehensive care program involving specialists from multiple medical disciplines may help reduce hospital readmissions associated with falls in older adults. The research team assessed the effects of a Senior Falls Initiative that included a comprehensive psychosocial interview, cognitive screening, assessment of judgment, ability to calculate medical numbers, health literacy screening, mood screening, alcohol abuse screening, and an insomnia inventory. Overall, they found that 8.8 percent of patients had no cognitive impairment, while 55.8 percent had an unknown cognitive impairment, and 35 percent had a dementia diagnosis. The team discussed patients’ level of functioning with the families of 82 percent of patients. Based on data from 558 patients, they found that the 30-day readmission rate for falls declined 10 percent from 2012 to 2013 and remained unchanged in 2014. In addition, the 30 to 90 day readmission rate also declined from 2012 to 2013, before seeing a slight rise in 2014. Read more…
Read the abstract (PDF)…
CDC experts offer advice on fighting antibiotic resistance.
Speaking at the interim meeting of the American Medical Association (AMA), representatives from the U.S. Centers for Disease Control and Prevention (CDC), offered advice on addressing the issue of antibiotic resistance. According to AMA Wire, speakers offered support for a multifaceted approach that includes increased education of physicians, a robust infrastructure for monitoring antibiotic use, testing of patients for asymptomatic colonization to prevent transmitting infections to other patients. Read more…
Learn more about the CDC Get Smart initiative…
MedPAC offers comments on CMS discharge-to-community quality measure and potentially preventable readmission measures.
The U.S. Medicare Payment Advisory Commission (MedPAC) has offered comments to the U.S. Centers for Medicare & Medicaid Services (CMS) regarding the development of a discharge-to-community quality measure and potentially preventable readmission measures for post-acute care (PAC) providers. The agency emphasizes the need for the measures to have a uniform definition, specification, and risk adjustment method. Among other things, MedPAC advises that risk adjustment models avoid factors that measure service use in the PAC setting, “because providers can control whether and how much service to furnish,” which could influence the care beneficiaries receive. Read more (PDF)…
Should physicians ditch the white coat?
A blog post on The New England Journal of Medicine Journal Watch website examines the issue of white physician coats, which some experts say may harbor infection. The writer notes that many physicians may not launder their coats very often, leading some experts to argue in favor of a “bare-below-the-elbows” approach to physician clothing. However, he also points out that there is a lack of definitive data on whether dressing in such a manner actually reduces infection rates. Read more…
Call for volunteers: Instructional Course Committees.
Dec. 18 is the last day to submit your application for a position on an Instructional Course Committee. Members of Instructional Course Committees grade Instructional Course Lecture applications in May and evaluate courses at the AAOS Annual Meeting. The following openings are available:
- Hand and Wrist (chair, one member)
- Shoulder and Elbow (one member)
- Trauma (chair, one member)
Applicants for these positions must be active fellows with a practice emphasis in the relevant topic. Learn more and submit your application…(member login required)
